艾司氯胺酮与氯胺酮在小儿眼科不插管全身麻醉手术中的应用效果  

Effect of Esketamine and Ketamine in pediatric ophthalmological surgery without intubation under general anesthesia

作　　者：闫国中 张雷光 余畅月 贺伟忠 YAN Guo-zhong;ZHANG Lei-guang;YU Chang-yue;HE Wei-zhong(Department of Anesthesiology,Kaifeng Central Hospital,Henan Kaifeng 475000,China;2.Color Ultrasonic Room,Kaifeng Central Hospital,Henan Kaifeng 475000,China)

机构地区：[1]开封市中心医院麻醉科,河南开封475000 [2]开封市中心医院彩超室,河南开封475000

出　　处：《临床药物治疗杂志》2022年第6期80-84,共5页Clinical Medication Journal

基　　金：开封市科技发展计划项目(2103044)。

摘　　要：目的比较艾司氯胺酮和氯胺酮联合右美托咪定在小儿眼科不插管全身麻醉(全麻)手术中的应用效果。方法收集2020年1月1日至2020年12月31日期间在开封市中心医院行眼科不插管全麻手术的患儿58例,按照随机数字表法分为观察组(n=29)和对照组(n=29),分别行艾司氯胺酮联合右美托咪定和氯胺酮联合右美托咪定麻醉方案。统计分析两组患儿术中不同时间点的平均动脉压(MAP)、心率(HR)、呼吸频率(RR)、脉搏血氧饱和度(SpO_(2))、麻醉前和手术开始时眼内压、麻醉起效时间、术后睁眼时间、麻醉苏醒时间、麻醉剂追加次数、术中体动及不良反应发生情况。结果两组患儿在各时间点的MAP、HR、RR、SpO_(2)以及麻醉起效时间、术后睁眼时间、麻醉剂追加情况和体动发生率差异均无统计学意义(均P>0.05);观察组麻醉苏醒时间、平均体动次数及不良反应发生率均显著低于对照组(均P<0.05)。结论氯胺酮与艾司氯胺酮在小儿眼科不插管全麻手术中的麻醉效果比较差异无统计学意义,但艾司氯胺酮不良反应率更低、苏醒时间更短,值得临床推广。Objective To compare the effect of Esketamine and Ketamine combined with Dexmedetomidine in pediatric ophthalmological surgery without intubation under general anesthesia.Methods Fifty-eight pediatrics who underwent ophthalmological surgery under general anesthesia in Kaifeng Central Hospital from January 1,2020 to December 31,2020 were enrolled and divided into the observation group(n=29)and control group(n=29)using random number table.Pediatrics in the observation group were given Esketamine combined with Dexmedetomidine anesthesia regimen and those in the control group were given Ketamine combined with Dexmedetomidine.The mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR)and pulse oxygen saturation(SpO_(2))at different time points during the surgery,intraocular pressure before anesthesia and at the beginning of surgery in the two groups were recorded.Then we analyzed the onset time of anesthesia,time of postoperative eye opening,anesthesia recovery time,times of anesthetics supplements,times of intraoperative body movement and adverse reactions in the two groups.Results Differences in MAP,HR,RR,SpO_(2),onset time of anesthesia,postoperative eye opening time,times of anesthetic addition and rate of body movement between the two groups at each time point were not statistically significant(all P>0.05).Compared with the control group,the anesthesia recovery time,the average number of body movements and the incidence of adverse reactions in the observation group were significantly lower(all P<0.05).Conclusion The anesthetic effect of Esketamine and Ketamine in pediatric ophthalmological operations under general anesthesia is similar,but the adverse reaction rate of Esketamine is lower and the recovery time is shorter,which is valuable in clinical promotion.

关 键 词：艾司氯胺酮 氯胺酮 右美托咪定 小儿眼科手术 

分 类 号：R971.2[医药卫生—药品] R779.6[医药卫生—药学]